Prevalence of Gestational Diabetes Mellitus and Pregnancy Outcomes in Women with Risk Factors Diagnosed by IADPSG Criteria at Bhumibol Adulyadej Hospital

Objective:To determine the prevalence and clinical outcomes of gestational diabetes mellitus (GDM), defined by IADPSG criteria, in pregnant women who are at risk of GDM.Study design: Descriptive study.Material and Method: We studied pregnant women who visited the antenatal clinics at Bhumibol Adulyadej Hospital between July 1, 2011 and December 31, 2012 and had risk factors of GDM. The diagnosis of GDM was defined using the IADPSG criteria. Primary outcome was the prevalence of GDM and the secondary outcomes were pregnancy related complications which included maternal and neonatal complications.Results: A total of 6,324 pregnancy women, 164 patients were diagnosed GDM. The prevalence of GDM was 2.6%. The most common clinical risk factor for GDM was age ≥30 years (75.4%). The most common maternal and neonatal complication were pregnancy induced hypertension (PIH) (12.7%) and hypoglycemia (47.6%). GDM women were significantly different from non-GDM women in PIH, primary cesarean section, hypoglycemia, Apgar <7, and NICU admission. Pregnancy outcomes between GDM A1 and A2 were significantly different. GDM A2 increased the rate of cesarean section, hypoglycemia, and NICU admission. Conclusion: Using the IADSP criteria, the prevalence of GDM was 2.6%. Compared to non-GDM regnant women, adversed pregnancy outcomes were significantly higher in GDM pregnant wome

Association of Fetal Growth Rate in First Trimester and Being Large or Small for Gestational Age

Objective:To evaluate the association of fetal growth rate in first trimester and fetal birth weight.Materials and Methods: The prospective cohort study was performed at the department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Bangkok, Thailand. Fetal growth rate was measured by ultrasound twice in first trimester. First Crown Rump Length (CRL) ultrasound was measured at first antenatal care (ANC) and second CRL ultrasound was at four weeks later. Delta CRLs was calculated and divided into 3 groups: larger than expected, smaller than expected and equal as expected. Patients were followed until delivery. Fetal birth weights were stratified and labeled as large for gestational age (LGA), small for gestational age (SGA) and appropriate for gestational age (AGA) by birth weight percentile at gestational age at delivery. Fetal growth rate in first trimester and fetal birth weight were analyzed.Result:114 pregnant women were recruited. 59 fetuses were equal as expected (51%), 43 fetuses were smaller than expected (38%) and 12 fetuses were larger than expected (11%). The delta CRLs were significantly associate to fetal birth weights (p < 0.005). Diabetic mellitus and hypertension were not significantly associated to fetal birth weights.Conclusion: Fetal growth rate in first trimester was significantly associated to fetal birth weight

Maternal and Neonatal Complications of Methamphetamine Use during Pregnancy

Background. Methamphetamine abuse has been a significant problem in Thailand. The methamphetamine abuse problem also affects pregnant women. The study of pregnancy outcomes among methamphetamine users during pregnancy is currently limited. Objective. To determine maternal and neonatal complications among methamphetamine-abusing parturients. Materials and method. This historical cohort study was conducted at Bhumibol Adulyadej Hospital (BAH), Bangkok, Thailand, between January 2017 and December 2019. The total number of women was 206 who were equally divided into a study and control group. Pregnant women who tested positive for methamphetamine in urine tests during the intrapartum period were compared to the control group with no history of drug abuse. Results. Maternal outcomes: gestational hypertension was found to be significantly increased in the study group compared to the control group at 14.6 vs. 1.0% (OR 17.4, 95%CI 2.5-134.3). Preeclampsia with and without severe features were found at higher rates in the study group without statistical significance. There were no eclamptic cases in this study. Neonatal outcomes: preterm birth rate of pregnant women who have tested positive in their urine methamphetamine test was significantly higher than in the control group (33.3%, 11.7%, OR 3.7, 95%CI 1.8-7.7). Average birth weight in the study and control group was 2779.1 ± 486.7 and 3049.5 ± 510 gm, respectively (p value < 0.001). Low APGAR score rates of both groups also had no significant difference. Conclusion. Methamphetamine use during pregnancy increased both maternal and neonatal complications in terms of gestational hypertension, preterm birth, and average birth weight

Recurrence Rate and Risk Factors for the Recurrence of Ovarian Endometriosis after Laparoscopic Ovarian Cystectomy

The aim of this study was to identify the recurrence rate and risk factors for the recurrence of ovarian endometriosis (OE) after laparoscopic cystectomy. This was a retrospective cross-sectional study. Subjects were OE cases who underwent laparoscopic ovarian cystectomy at Bhumibol Adulyadej Hospital (BAH). The period of this study was from January 2008 to December 2017. Ovarian histopathology and at least one-year follow-up after surgery were the prerequisite requirements. A total of 106 OE cases were included in the study. Subjects were classified into recurrence and nonrecurrence groups. It comprised of 24 and 82 cases, respectively. The mean age of the participant was 32.4 years old. The demographic characters of both groups were comparable. The recurrence rate after laparoscopic OE surgery in the present study was 22.6% (24/106). The average largest diameter of OE in the present study was 54.5 mm. Postoperative medical treatment (OR 3.15, 95% CI 1.14-8.74, p=0.02) and postoperative pregnancy (OR 2.86, 95% CI 1.03-7.93, p=0.04) were associated factors for recurrence decrement. The recurrence rate of OE after laparoscopic cystectomy was 22.6%. Postoperative medical treatment and postoperative pregnancy were a significant factor that lowered OE recurrence